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Stomach and Intestine(Tokyo) Volume 8, Issue 2 （February 1973）

胃と腸 8巻2号（1973年2月発行）

Japanese English

今月の主題消化管の悪性リンパ腫

症例

早期胃細網肉腫の1例 A Case of Early Reticulum Cell Sarcoma 杉山憲義 ¹ , 熊倉賢二 ¹ , 丸山雅一 ¹ , 竹腰隆男 ¹ , 氏家紘一 ¹ , 寺崎茂宏 ¹ , 佐々木喬敬 ¹ , 江村武志 ¹ , 関正威 ² , 高木国夫 ² , 西俣嘉人 ³ , 馬場保晶 ³ , 遠藤次彦 ³ , 中村恭一 ³ N. Sugiyama ¹ , K. Kumakura ¹ , M. Maruyama ¹ , K. Takagi ² , K. Nakamura ³ ¹癌研究会附属病院内科 ²癌研究会附属病院外科 ³癌研究会附属病院病理 ¹Dept. of Int. Med., Cancer Institute Hospital ²Dept. of Surgery, Cancer Institute Hospital ³Dept. of Pathology, Cancer Institute Hospital pp.187-193

発行日 1973年2月25日 Published Date 1973/2/25

DOI https://doi.org/10.11477/mf.1403108360

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Abstract 文献概要
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　癌研外科で1946年から1971年までの問に切除された胃細網肉腫は36例であった．早期胃癌の定義に準拠して，細網肉腫が粘膜下層までに限局したものを早期胃細網肉腫とみなすと，36例中4例がそれにあたる．

　今回，術前に進行癌と考えられて切除された早期胃細網肉腫1例について報告する．

　A forty-one-year-old male patient came to the Cancer Institute Hospital with a chief complaint of epigastralgia. X-ray examination of the stomach was performed. Barium-filled film revealed narrowing of the gastric antrum. The mucosa of the narrowed portion seemed mostly normal on the double contrast images, but the proximal end of the narrowing, especially that around the greater curvature side, was irregularly granulated. A compression image revealed two niches at the distal portion of the narrowing, and another compression image revealed a faint collection of barium at the proximal, greater curvature side of the narrowing. The faint barium shadow looked as irregular as that observed in a case of early gastric cancer.

　Endoscopically, a shallow depression of the mucosa with a slightly elevated margin was seen at the greater curvature aspect of the antrum. It was not well circumscribed from the surrounding normal mucosa and its surface was granulated. There were seen other two small ulcers at the distal portion of the narrowed antrum.

　In the biopsy studies performed two times, a diagnosis of adenocarcinoma scirrhosum was made. On the resected specimen, there was an irregular depression of the mucosa with a slightly elevated margin measuring 35×30 mm at the greater curvature aspect of the antrum, and yellowish discoloration including the lesions was observed in the greater part of the antum. There were also two symmetrical ulcer scars (kissing ulcer) near the pyloric ring.

　Histological examination of the irregular depression disclosed reticulum cell sarcoma (RCS) which was limited to the submucosa. It may be called “early reticulum cell sarcoma”, if the definition of early gastric cancer be adopted. The discoored portion corresponded to an extensive fibrosis of the submucosa of the antrum. Two symmetrical ulcer scars were proved to be benign (Ul-ⅡS).